turks & caicos islands department of economic … · 1. turks & caicos islands 2. bahamas...
TRANSCRIPT
CONFIDENTIAL
TURKS & CAICOS ISLANDS DEPARTMENT OF ECONOMIC PLANNING AND STATISTICS
Commonwealth Caribbean Population and Housing Census
May 2001
Island No. Locality E.D. No.
Name of Respondent: _________________________________ Telephone Number: Address of Household: _______________________________________________________ ________________________________________________________ Building Number: Dwelling Unit Number: Household Number: Number of persons in household: Total Number of questionnaires: Questionnaire number:
RECORD OF VISITS
INTERVIEWER CALLS
1
2
3
4
DATE
TIME STARTED/VISITED
TIME ENDED
DURATION
RESULT*
*Result Codes: 1 = Completed 5 = No Contact 2 = Incomplete - Call back 6 = Closed Dwelling 3 = Incomplete - Interview Terminated 7 = Vacant Dwelling 4 = Refused 9 = Other __________________________ (Please Specify)
Enumerator’s Name: _________________________ Signature/Initials: _________________________ Date: _________________________ Field Editor’s Name: _________________________ Signature/Initials: _________________________ Date: _________________________ Supervisor’s Name: _________________________ Signature/Initials: _________________________ Date: _________________________ Editor’s Name: _________________________ Signature/Initials: _________________________ Date: _________________________ Coder’s Name: _________________________ Signature/Initials: _________________________ Date: _________________________
LIST OF HOUSEHOLD MEMBERS
NO. SURNAME FIRST NAME MALE FEMALE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
INTERVIEWER SAY: Please give me the names of all the persons who usually live here and share at least one daily meal.
Head of Household
2nd Person
3rd Person
First Name
SECTION 1. CHARACTERISTICS OF THE HOUSEHOLD
FOR ALL PERSONS 1.1. What is ____________ relationship to the head of the household?
1. Head
2. Spouse/partner
3. Child
4. Son/ Daughter-in-law
5. Grandchild
6. Parent/ Parent-in-law
7. Other relative
8. Non-relative
1. Head
2. Spouse/partner
3. Child
4. Son/ Daughter-in-law
5. Grandchild
6. Parent/ Parent-in-law
7. Other relative
8. Non-relative
1. Head
2. Spouse/partner
3. Child
4. Son/ Daughter-in-law
5. Grandchild
6. Parent/ Parent-in-law
7. Other relative
8. Non-relative 1.2. What is ____________ sex?
1. Male
2. Female
1. Male
2. Female
1. Male
2. Female
1.3. What is __________date of birth? If not known ask, “How old was _______________ on his/her last birthday?”
1. Date of Birth
day month year
2. Age in years
1. Date of Birth
day month year
2. Age in years
1. Date of Birth
day month year
2. Age in years
1.4. To what ethnic or racial group does ____________________ belong?
1. African/Negro/Black
2. White
3. East Indian
4. Mixed (state 2 main ethnic types) 4.1 _____________________ 4.2 ____________________
5. Other______________ (Specify)
1. African/Negro/Black
2. White
3. East Indian
4. Mixed (state 2 main ethnic types) 4.1 _____________________ 4.2 ____________________
5. Other______________ (Specify)
1. African/Negro/Black
2. White
3. East Indian
4. Mixed (state 2 main ethnic types) 4.1 _____________________ 4.2 ____________________
5. Other______________ (Specify)
1.5. To which religious denomination does ____________ belong?
1. Baptist
2. Methodist
3. Anglican
4. Church of God
5. Seventh Day Adventist
6. Roman Catholic
7. Jehovah’s Witness
8. Other ______________ (Specify)
9. None
1. Baptist
2. Methodist
3. Anglican
4. Church of God
5. Seventh Day Adventist
6. Roman Catholic
7. Jehovah’s Witness
8. Other ______________ (Specify)
9. None
1. Baptist
2. Methodist
3. Anglican
4. Church of God
5. Seventh Day Adventist
6. Roman Catholic
7. Jehovah’s Witness
8. Other ______________ (Specify)
9. None
SECTION 2. BIRTH PLACE AND RESIDENCE
2.1. Where was__________ born?
1. Turks & Caicos Islands
2. Abroad (Skip to 2.4)
1. Turks & Caicos Islands
2. Abroad (Skip to 2.4 )
1. Turks & Caicos Islands
2. Abroad (Skip to 2.4 ) 2.2. Which Island was this?
1. Grand Turk
2. Providenciales
3. South Caicos
4. North Caicos
5. Middle Caicos
6. Salt Cay
1. Grand Turk
2. Providenciales
3. South Caicos
4. North Caicos
5. Middle Caicos
6. Salt Cay
1. Grand Turk
2. Providenciales
3. South Caicos
4. North Caicos
5. Middle Caicos
6. Salt Cay
2.3 Has __________ ever lived abroad (In another country)?
1. Yes
2. No (Skip to 2.6)
1. Yes
2. No (Skip to 2.6)
1. Yes
2. No (Skip to 2.6)
2.4. In which country did ________________ last reside?
1. Bahamas
2. USA
3. Canada
4. England
5. Haiti
6. Dominican Republic
7. Other. _____________ (Specify)
1. Bahamas
2. USA
3. Canada
4. England
5. Haiti
6. Dominican Republic
7. Other. _____________ (Specify)
1. Bahamas
2. USA
3. Canada
4. England
5. Haiti
6. Dominican Republic
7. Other. _____________ (Specify)
2.5. In what year did _________ leave that country to come to the Turks & Caicos Islands to live?
1. Year
1. Year
1. Year
2.6. Did _________ live in another Turks & Caicos Island before this one?
1. Yes
2. No (Skip to 2.9)
1. Yes
2. No (Skip to 2.9)
1. Yes
2. No (Skip to 2.9) 2.7. In which island was this?
1. Grand Turk
2. Providenciales
3. South Caicos
4. North Caicos
5. Middle Caicos
6. Salt Cay
1. Grand Turk
2. Providenciales
3. South Caicos
4. North Caicos
5. Middle Caicos
6. Salt Cay
1. Grand Turk
2. Providenciales
3. South Caicos
4. North Caicos
5. Middle Caicos
6. Salt Cay
2.8. In what year did ____________ move/come to live in this island?
1. Year 1. Year 1. Year
2.9 Where was _________ living: 2.9.1 Ten (10)
years ago.
2.9.2 Five (5) years ago.
2.9.3 One (1) one year ago
Address _______________________ _______________________ Address _______________________ _______________________ Address _______________________ _______________________
Address _______________________ _______________________ Address _______________________ _______________________ Address _______________________ _______________________
Address _______________________ _______________________ Address _______________________ _______________________ Address _______________________ _______________________
2.10 Of what country is _______________ a citizen?
1. Turks & Caicos Islands
2. Bahamas
3. USA
4. Canada
5. England
6. Haiti
7. Dominican Republic
8. Other. _____________ (Specify) If not citizen of Turks & Caicos Islands (Go to Section 3)
1. Turks & Caicos Islands
2. Bahamas
3. USA
4. Canada
5. England
6. Haiti
7. Dominican Republic
8. Other. _____________ (Specify) If not citizen of Turks & Caicos Islands (Go to Section 3)
1. Turks & Caicos Islands
2. Bahamas
3. USA
4. Canada
5. England
6. Haiti
7. Dominican Republic
8. Other. _____________ (Specify) If not citizen of Turks & Caicos Islands (Go to Section 3)
2.11 If _________________ is a Turks & Caicos Island citizen, by what method did _________ acquire citizenship?
1. Born to Turks & Caicos Islands parents.
2. Born in Turks & Caicos to Non- Turks & Caicos Islander parents.
3. Adopted by Turks & Caicos Islanders
4. Married to a Turks & Caicos Islander husband
5. Married to Turks & Caicos Islander Wife.
6. Other Naturalization ____________________ (Specify)
1. Born to Turks & Caicos Islands parents.
2. Born in Turks & Caicos to Non- Turks & Caicos Islander parents.
3. Adopted by Turks & Caicos Islanders
4. Married to a Turks & Caicos Islander husband
5. Married to Turks & Caicos Islander Wife.
6. Other Naturalization ____________________ (Specify)
1. Born to Turks & Caicos Islands parents.
2. Born in Turks & Caicos to Non- Turks & Caicos Islander parents.
3. Adopted by Turks & Caicos Islanders
4. Married to a Turks & Caicos Islander husband
5. Married to Turks & Caicos Islander Wife.
6. Other Naturalization ____________________ (Specify)
SECTION 3. MARITAL STATUS/UNION STATUS
FOR PERSONS 15 YEARS AND OVER 3.1. What is___________ legal marital status?
1. Married
2. Widowed
3. Legally Separated
4. Divorced
5. Never Married (Interviewer: if 2, 3, 4, or 5 is ticked skip to 3.3)
1. Married
2. Widowed
3. Legally Separated
4. Divorced
5. Never Married (Interviewer: if 2, 3, 4, or 5 is ticked skip to 3.3)
1. Married
2. Widowed
3. Legally Separated
4. Divorced
5. Never Married (Interviewer: if 2, 3, 4, or 5 is ticked skip to 3.3)
3.2. Is_____________ currently living with his/her wife/husband?
1. Yes (Skip to 3.4)
2. No
1. Yes (Skip to 3.4)
2. No
1. Yes (Skip to 3.4)
2. No
3.3. Is________ currently living with a common - law partner?
1. Yes
2. No
1. Yes
2. No
1. Yes
2. No
3.4. How old was _____________ when he/she was first married or lived with a common law partner?
Age in years
Age in years Age in years
SECTION 4. EDUCATION AND TRAINING
4.1. Is ______________ attending any school or educational institution now?
1. Yes
2. No (Skip to 4.6)
2. Yes
3. No (Skip to 5.6)
4. Yes
5. No (Skip to 5.6)
4.2 Is ______________
attending full-time or part-time?
1. Full-time
2. Part-time
1. Full-time
2. Part-time
1. Full-time
2. Part-time
4.3. What type of institution is ____________ attending?
1. Nursery/Infant/ Kindergarten/Pre- school
2. Primary
3. Secondary
4. Community College
5. Other______________ (Specify)
1. Nursery/Infant/ Kindergarten/Pre- school
2. Primary
3. Secondary
4. Community College
5. Other______________ (Specify)
1. Nursery/Infant/ Kindergarten/Pre- school
2. Primary
3. Secondary
4. Community College
5. Other______________ (Specify)
4.4. Please give the name and address of the school or institution.
Name _________________________ Address _______________________ _______________________
Name _________________________ Address _______________________ _______________________
Name _________________________ Address _______________________ _______________________
4.5. What is ____________ main mode of travel to the school or institution?
1. Walk
2. Bicycle
3. Private Car or vehicle
4. Public Vehicle (Bus etc.)
5. Hired Transport (taxi/minibus/jitney)
6. Other ______________ (Specify)
1. Walk
2. Bicycle
3. Private Car or vehicle
4. Public Vehicle (Bus etc.)
5. Hired Transport (taxi/minibus/jitney)
6. Other ______________ (Specify)
1. Walk
2. Bicycle
3. Private Car or vehicle
4. Public Vehicle (Bus etc.)
5. Hired Transport (taxi/minibus/jitney)
6. Other ______________ (Specify)
4.6. What is the highest level of education that ________________ has reached?
1. Nursery/ Kindergarten
2. Primary
3. Secondary
4. Pre-University/Post Secondary
5. University
6. Other _____________ (Specify)
7. None
1. Nursery/ Kindergarten
2. Primary
3. Secondary
4. Pre-University/Post Secondary
5. University
6. Other _____________ (Specify)
7. None
1. Nursery/ Kindergarten
2. Primary
3. Secondary
4. Pre-University/Post Secondary
5. University
6. Other _____________ (Specify)
7. None
4.7. YEARS OF SCHOOLING AT HIGHEST LEVEL How many years of schooling at the highest level of education did _______________ attain?
1. Less than a year
2. One Year or less
3. Two Years or less
4. Three Years or less
5. Four Years or less
6. Five Years or less
7. Six Years or less
8. Seven Years or More
1. Less than a year
2. One Year or less
3. Two Years or less
4. Three Years or less
5. Four Years or less
6. Five Years or less
7. Six Years or less
8. Seven Years or More
1. Less than a year
2. One Year or less
3. Two Years or less
4. Three Years or less
5. Four Years or less
6. Five Years or less
7. Six Years or less
8. Seven Years or More
4.8. HIGHEST EXAMINATION EVER PASSED What is the highest exam __________________ has ever passed?
1. None
2. School Leaving
3. CXC Basic
4. G.C.E. ‘O’/CXC General Prof. 1 or 2 subjects
5. G.C.E. ‘O’/CXC General Prof. 3 or 4 subjects;
6. G.C.E. ‘O’/CXC General Prof. 5 subjects and over
7. G.C.E. ‘A’ 1 or 2 subjects
8. G.C.E. ‘A’/3 subjects and over
9. Diploma or Equivalent Certificate of Achievement
10. Associate Degree
11. First Degree
12. Higher Degree
11. Other______________ (Specify)
INTERVIEWER: Exclude Common Entrance and
14+ Exams
1. None
2. School Leaving
3. CXC Basic
4. G.C.E. ‘O’/CXC General Prof. 1 or 2 subjects
5. G.C.E. ‘O’/CXC General Prof. 3 or 4 subjects;
6. G.C.E. ‘O’/CXC General Prof. 5 subjects and over
7. G.C.E. ‘A’ 1 or 2 subjects
8. G.C.E. ‘A’/3 subjects and over
9. Diploma or Equivalent Certificate of Achievement
10. Associate Degree
11. First Degree
12. Higher Degree
12. Other______________ (Specify)
INTERVIEWER: Exclude Common Entrance and
14+ Exams
1. None
2. School Leaving
3. CXC Basic
4. G.C.E. ‘O’/CXC General Prof. 1 or 2 subjects
5. G.C.E. ‘O’/CXC General Prof. 3 or 4 subjects;
6. G.C.E. ‘O’/CXC General Prof. 5 subjects and over
7. G.C.E. ‘A’ 1 or 2 subjects
8. G.C.E. ‘A’/3 subjects and over
9. Diploma or Equivalent Certificate of Achievement
10. Associate Degree
11. First Degree
12. Higher Degree
13. Other______________ (Specify)
INTERVIEWER: Exclude Common Entrance and 14+
Exams
TRAINING FOR PERSONS 15 YEARS & OVER
4.9. Has _____________ pursued any course of formal training for at least 3 months?
1. Yes
2. No
1. Yes
2. No
1. Yes
2. No
4.10. How was this training received?
1. Correspondence Course
2. Distance Learning
3. On the job
4. Apprenticeship
5. At an Institution
6. Other _______________ (Specify)
1. Correspondence Course
2. Distance Learning
3. On the job
4. Apprenticeship
5. At an Institution
6. Other _______________ (Specify)
1. Correspondence Course
2. Distance Learning
3. On the job
4. Apprenticeship
5. At an Institution
6. Other _______________ (Specify)
4.11 . For what occupation does this training prepare ____________________?
SECTION 5. ECONOMIC ACTIVITY
FOR ALL PERSONS FIFTEEN (15) YEARS OLD AND OVER
5.1. ECONOMIC ACTIVITY PAST WEEK Which of the following best describes your work status during the past week?
1. Had a job, worked
(Go to 6.4)
2. Had a job, did not work (Go to 6.4)
3. Seeking first job (Go to Section 6)
4. Actively looked for a job (not first job)
5. Did not look for a job but wanted work was available
6. Did not look and was not available
1. Had a job, worked (Go to 6.4)
2. Had a job, did not work (Go to 6.4)
3. Seeking first job (Go to Section 6)
4. Actively looked for a job (not first job)
5. Did not look for a job but wanted work was available
6. Did not look and was not available
1. Had a job, worked (Go to 6.4)
2. Had a job, did not work (Go to 6.4)
3. Seeking first job (Go to Section 6)
4. Actively looked for a job (not first job)
5. Did not look for a job but wanted work was available
6. Did not look and was not available
5.2. REASON FOR NOT SEEKING WORK PAST WEEK Why did _____________ not look for work during the past week?
1. At school/student
2. Home duties
3. Retired
4. Disabled
5. Did not want to work
6. Awaiting a job
7. Knew of no vacancy
8. Discouraged
9. Temporary illness
10.Other______________ (Specify)
1. At school/student
2. Home duties
3. Retired
4. Disabled
5. Did not want to work
6. Awaiting a job
7. Knew of no vacancy
8. Discouraged
9. Temporary illness
10.Other______________ (Specify)
1. At school/student
2. Home duties
3. Retired
4. Disabled
5. Did not want to work
6. Awaiting a job
7. Knew of no vacancy
8. Discouraged
9. Temporary illness
10.Other______________ (Specify)
5.3. LAST LOOKED FOR WORK When did _________________ last look for work?
1. Under 1 month
2. 1-3 months ago
3. 4-6 months ago
4. 7-11 months ago
5. 1-4 years ago
6. 5 years ago and over
7. Never looked for work
1. Under 1 month
2. 1-3 months ago
3. 4-6 months ago
4. 7-11 months ago
5. 1-4 years ago
6. 5 years ago and over
7. Never looked for work
1. Under 1 month
2. 1-3 months ago
3. 4-6 months ago
4. 7-11 months ago
5. 1-4 years ago
6. 5 years ago and over
7. Never looked for work
5.4 Was this ___________ first job? 1. Yes
2. No
1. Yes
2. No
1. Yes
2. No 5.5. During that week, how many paid jobs did ____________ work at?
1. One
2. Two
3. Three or more
4. None
1. One
2. Two
3. Three or more
4. None
1. One
2. Two
3. Three or more
4. None
5.6 How many hours did _______________ work on his/her main job during that week?
1. 1-8
2. 9-15
3. 16-32
4. 33-44
5. 45 and over
6. None
1. 1-8
2. 9-15
3. 16-32
4. 33-44
5. 45 and over
6. None
1. 1-8
2. 9-15
3. 16-32
4. 33-44
5. 45 and over
6. None
5.7 What is the name of the company/ business where _____________ works or for which ____________ last worked? (This and following questions refer to main job)
1.Business Name _________________________
1.Business Name _________________________
1.Business Name _________________________
5.8 What kind of business or activity takes place there? (Describe the kind of business e.g. retail store, primary school, law firm, brewery, etc.)
1.Activity _________________________
1.Activity _________________________
1.Activity _________________________
5.9 What type of work ________ does/did you do there? (Describe your job as accurately as possible e.g. sales clerk, typist, doctor, auto mechanic, civil engineer, taxi driver, housemaid, etc.) (Do Not say engineer, mechanic, teacher, supervisor, clerk, etc. Be more specific e.g. sales clerk, primary school teacher, auto mechanic, etc.)
5.10 Which best applies to ______________?.
1. Has own business with no paid helper
2. Has own business with paid helper
3. Worked for a wage or salary as private employee
4. Government Employee
5. Learner/Apprentice
6. Unpaid worker in family business
1. Has own business with no paid helper
2. Has own business with paid helper
3. Worked for a wage or salary as private employee
4. Government Employee
5. Learner/Apprentice
6. Unpaid worker in family business
1. Has own business with no paid helper
2. Has own business with paid helper
3. Worked for a wage or salary as private employee
4. Government Employee
5. Learner/Apprentice
6. Unpaid worker in family business
SECTION 6. FERTILITY
FOR FEMALES FIFTEEN (15) YEARS OF AGE AND OVER 6.1. How many live births did____________ ever have?
6.2. How old was _______ when __________ had the first live birth?
6.3. How old was _______ when ________had the last live birth?
6.4. How many live-birth(s) did _____________ have in the last twelve (12) months?
6.5. Please state the sex(es) of this/these live births?
1. Male
2. Female
1. Male
2. Female
1. Male
2. Female
6.6. Did any of these live-births die?
6.7. How many?
6.8. What was the sex(es) of the live-births?
1. Yes
2. No (skip to Q
6.9)
1. Male
2. Female
1. Yes
2. No (skip to Q
6.9)
1. Male
2. Female
1. Yes
2. No (skip to Q 6.9)
1. Male
2. Female
6.9 How many still-birth(s) did _____________ have in the last twelve (12) months?
SECTION 7. DISABILITY, HEALTH, AND NUTRITION
7.1. Does_______________ suffer from any of the following long lasting conditions?
1. Blindness
2. Severe Vision Impairment
3. Deafness
4. Severe Hearing Impairment
5. Dumbness
6. Speech Impediment INTERVIEWER: Multiple responses can be ticked.
1. Blindness
2. Severe Vision Impairment
3. Deafness
4. Severe Hearing Impairment
5. Dumbness
6. Speech Impediment INTERVIEWER: Multiple responses can be ticked.
1. Blindness
2. Severe Vision Impairment
3. Deafness
4. Severe Hearing Impairment
5. Dumbness
6. Speech Impediment INTERVIEWER: Multiple responses can be ticked.
7.2.Which of the following basic activities are affected by any long lasting condition that you may have?
1. Walking, Standing, Climbing Stairs
2. Reaching, Lifting, Kneeling, Carrying
3. Gripping
4. Seeing
5. Hearing
6. Speaking/Talking
7. Learning, remembering, concentrating
8. Behavioural INTERVIEWER: Multiple responses can be ticked.
1. Walking, Standing, Climbing Stairs
2. Reaching, Lifting, Kneeling, Carrying
3. Gripping
4. Seeing
5. Hearing
6. Speaking/Talking
7. Learning, remembering, concentrating
8. Behavioural INTERVIEWER: Multiple responses can be ticked.
1. Walking, Standing, Climbing Stairs
2. Reaching, Lifting, Kneeling, Carrying
3. Gripping
4. Seeing
5. Hearing
6. Speaking/Talking
7. Learning, remembering, concentrating
8. Behavioural INTERVIEWER: Multiple responses can be ticked.
7.3.Does________________ disability or condition affect _________ from performing any of the following activities:
1. Taking Care of Yourself
2. Getting Around within the Home
3. Going Outside the Home
4. Working at a Job or Business
5. Undertaking Educational Activities
6. Communicating INTERVIEWER: Multiple responses can be ticked.
1. Taking Care of Yourself
2. Getting Around within the Home
3. Going Outside the Home
4. Working at a Job or Business
5. Undertaking Educational Activities
6. Communicating INTERVIEWER: Multiple responses can be ticked.
1. Taking Care of Yourself
2. Getting Around within the Home
3. Going Outside the Home
4. Working at a Job or Business
5. Undertaking Educational Activities
6. Communicating INTERVIEWER: Multiple responses can be ticked.
HEALTH FOR ALL PERSONS
7.4 What is ___________ weight and height? Weight
Lbs
Height ft inches
Weight Lbs
Height ft inches
Weight Lbs
Height ft inches
7.5 CHRONIC ILLNESS Does _________ suffer from any of the following diseases:
1. Arthritis
2. Asthma
3. Diabetes
4. Hypertension
5. Heart Disease
6. Kidney Disease
7. Cancer
8. HIV/AIDS
9. Lupus
10. Sickle Cell Anemia
11. Obesity
12. Other_____________ (Specify)
INTERVIEWER: Multiple responses can be ticked
1. Arthritis
2. Asthma
3. Diabetes
4. Hypertension
5. Heart Disease
6. Kidney Disease
7. Cancer
8. HIV/AIDS
9. Lupus
10. Sickle Cell Anemia
11. Obesity
12. Other_____________ (Specify)
INTERVIEWER: Multiple responses can be ticked
1. Arthritis
2. Asthma
3. Diabetes
4. Hypertension
5. Heart Disease
6. Kidney Disease
7. Cancer
8. HIV/AIDS
9. Lupus
10. Sickle Cell Anemia
11. Obesity
12. Other_____________ (Specify)
INTERVIEWER: Multiple responses can be ticked
7.6 UTILISATION OF MEDICAL FACILITY Has __________ visited a medical facility in the past month?
1. Yes
2. No
1. Yes
2. No
1. Yes
2. No
7.7. TYPE OF MEDICAL FACILITY What type of medical facility has ______________ visited in the past 6 months?
1. Public Hospital (local)
2. Public Health Center (local)
3. Public Maternity Unit (local)
4. Public Hospital (abroad)
5. Public Health Center (abroad)
6. Public Maternity Unit (abroad)
7. Private Doctor’s Office (local)
8. Private Doctor’s Office (abroad)
9. Pharmacy (local)
10. Pharmacy (abroad)
11. Other ______________ (Specify)
1. Public Hospital (local)
2. Public Health Center (local)
3. Public Maternity Unit (local)
4. Public Hospital (abroad)
5. Public Health Center (abroad)
6. Public Maternity Unit (abroad)
7. Private Doctor’s Office (local)
8. Private Doctor’s Office (abroad)
9. Pharmacy (local)
10. Pharmacy (abroad)
11. Other ______________ (Specify)
1. Public Hospital (local)
2. Public Health Center (local)
3. Public Maternity Unit (local)
4. Public Hospital (abroad)
5. Public Health Center (abroad)
6. Public Maternity Unit (abroad)
7. Private Doctor’s Office (local)
8. Private Doctor’s Office (abroad)
9. Pharmacy (local)
10. Pharmacy (abroad)
11. Other ______________ (Specify)
7.8. HEALTH INSURANCE Is ____________ covered by health insurance and/or Employee Medical Plan?
1. Yes
2. No
3. Don’t Know
1. Yes
2. No
3. Don’t Know
1. Yes
2. No
3. Don’t Know
SECTION 8. TRANSPORTATION AND TRAVEL
FOR PERSONS FIFTEEN (15) YEARS OF AGE AND OVER 8.1. What is ____________ main form of transportation?
1. Walk
2. Bicycle
3. Motorcycle
4. Jitney
5. Private Vehicle
6. Taxi
7. Boat
8. Ferry
9. Airplane
10. Other ____________ (Specify)
1. Walk
2. Bicycle
3. Motorcycle
4. Jitney
5. Private Vehicle
6. Taxi
7. Boat
8. Ferry
9. Airplane
10. Other ____________ (Specify)
1. Walk
2. Bicycle
3. Motorcycle
4. Jitney
5. Private Vehicle
6. Taxi
7. Boat
8. Ferry
9. Airplane
10. Other ________________ (Specify)
8.2. In the past year which countries did _____________ visit for the following purposes? For each Country reported please indicate the number of times visited in the past six months
1.Vacation
__________________
__________________
__________________ 2. Shopping
_________________
_________________
_________________ 3. Business/Conference
_________________
_________________
_________________ 4. Medical
_________________
_________________
_________________ 5. Study
_________________
_________________
_________________ 6. Other (Specify)
_________________
_________________ 7 Didn’t Travel
1.Vacation
__________________
__________________
__________________ 2. Shopping
_________________
_________________
_________________ 3. Business/Conference
_________________
_________________
_________________ 4. Medical
_________________
_________________
_________________ 5. Study
_________________
_________________
_________________ 6. Other (Specify)
_________________
_________________ 7 Didn’t Travel
1.Vacation
__________________
__________________
__________________ 2. Shopping
_________________
_________________
_________________ 3. Business/Conference
_________________
_________________
_________________ 4. Medical
_________________
_________________
_________________ 5. Study
_________________
_________________
_________________ 6. Other (Specify)
_________________
_________________ 7 Didn’t Travel
SECTION 9. INCOME
(PERSONS FIFTEEN (15) YEARS OF AGE AND OVER)
9.1 During the past twelve months did __________________ receive income from any of these sources? If so, state amount in the space provided. (US$. to the nearest whole number e.g. 12565.80=12566)
(PRIMARY JOB) 1. Wages, Salary, Commission, Tips, etc. (SECONDARY JOB) 2. Wages, Salary, Commission, Tips, etc. 3. Own Business 4. Retirement Pension 5. Old Age Pension 6. Government Allowances 7. Gifts and Donations 8. Investments 9. Other Sources 10. Total Income During Last Twelve Months
(PRIMARY JOB) 1. Wages, Salary, Commission, Tips, etc. (SECONDARY JOB) 2. Wages, Salary, Commission, Tips, etc. 3. Own Business 4. Retirement Pension 5. Old Age Pension 6. Government Allowances 7. Gifts and Donations 8. Investments 9. Other Sources 10. Total Income During Last Twelve Months
(PRIMARY JOB) 1. Wages, Salary, Commission, Tips, etc. (SECONDARY JOB) 2. Wages, Salary, Commission, Tips, etc. 3. Own Business 4. Retirement Pension 5. Old Age Pension 6. Government Allowances 7. Gifts and Donations 8. Investments 9. Other Sources 10. Total Income During Last Twelve Months
SECTION 10. FOR ALL PERSONS
WHERE DID YOU SPEND CENSUS NIGHT IMPORTANT INTERVIEWER: If interview was conducted before census day, ask on return visit, immediately after
Census day. If the interview was conducted after census day, ask as part of the full interview.
WHERE DID YOU SPEND CENSUS NIGHT?
10.1. Where did ________ spend census night?
1. At this address (end interview)
2. Elsewhere in this country
3. Outside Turks and Caicos Islands (end interview)
1. At this address (end interview)
2. Elsewhere in this country
3. Outside Turks and Caicos Islands (end interview)
1. At this address (end interview)
2. Elsewhere in this country
3. Outside Turks and Caicos Islands (end interview)
10.2. What part of the country was . . .? If known please specify. INTERVIEWER: Write as full an address as possible.
SECTION 11: EMIGRATION AND MORTALITY
ALL PERSONS
11.1. Did anyone in this household move to live abroad between 1990 and 2001 and are still abroad?
1. YES [IF YES CONTINUE]
2. NO [IF NO GO TO SECTION 5]
1. YES [IF YES CONTINUE]
2. NO [IF NO GO TO SECTION 5]
1. YES [IF YES CONTINUE]
2. NO [IF NO GO TO SECTION 5]
11.2. How many persons moved?
11.3 Sex
1. Male
2. Female
1. Male
2. Female
1. Male
2. Female
11.4 Year moved?
11.5 Age when moved?
11.6 Marital status when moved?
11.7 Occupation when moved?
11.8 Country of migration?
11.9 Did any members of this household die between 1990 and the present time?
1. Yes
2. No
1. Yes
2. No
1. Yes
2. No
11.10 How many?
11.11 Please give me the sex of the person who died.
1. Male
2. Female
1. Male
2. Female
1. Male
2. Female 11.12 Please give me the age of the person who died.
11.13 PLACE OF BIRTH
Where was _________ place of birth?
SECTION 12. CRIME
12.1 Has any member of your household been a victim of a crime during the period of January 2001 to present ?
1. Yes
2. No (If “No” go to Section 13)
1. Yes
2. No (If “No” go to Section 13)
1. Yes
2. No (If “No” go to Section 13)
12.2 What was the nature of the crime.
1. Crime against the person
a. Wounding
b. Murder
c. Attempted murder
d. Manslaughter
e. inflicting Bodily Injuries
f. Administering poison so as to endanger life
g. Assault
h. Assault occasioning actual bodily harm
i. Rape
j. Attempted Rape
k. Carnal Knowledge
l. Bigamy
m. Concealment of birth
n. Robbery
o. Abortion
p. Supplying drugs to cause abortion.
1. Crime against the person
a. Wounding
b. Murder
c. Attempted murder
d. Manslaughter
e. inflicting Bodily Injuries
f. Administering poison so as to endanger life
g. Assault
h. Assault occasioning actual bodily harm
i. Rape
j. Attempted Rape
k. Carnal Knowledge
l. Bigamy
m. Concealment of birth
n. Robbery
o. Abortion
p. Supplying drugs to cause abortion.
1. Crime against the person
a. Wounding
b. Murder
c. Attempted murder
d. Manslaughter
e. inflicting Bodily Injuries
f. Administering poison so as to endanger life
g. Assault
h. Assault occasioning actual bodily harm
i. Rape
j. Attempted Rape
k. Carnal Knowledge
l. Bigamy
m. Concealment of birth
n. Robbery
o. Abortion
p. Supplying drugs to cause abortion.
2. Crime against property
a. Arson
b. Malicious Damage
c. Theft
d. Burglary
e. Taking Motor vehicle without consent
f. Interference with vehicle
g. Handling stolen goods
h. Obtaining property by deception
i. Obtaining services by deception
j. making off without payment
k. False Accounting 3. Other ________________ (specify)
2. Crime against property
a. Arson
b. Malicious Damage
c. Theft
d. Burglary
e. Taking Motor vehicle without consent
f. Interference with vehicle
g. Handling stolen goods
h. Obtaining property by deception
i. Obtaining services by deception
j. Making off without payment
k. False Accounting 3. Other ________________ (specify)
2. Crime against property
a. Arson
b. Malicious Damage
c. Theft
d. Burglary
e. Taking Motor vehicle without consent
f. Interference with vehicle
g. Handling stolen goods
h. Obtaining property by deception
i. Obtaining services by deception
j. Making off without payment
k. False Accounting 3. Other ________________ (specify)
12.3 Was the crime reported?
1. Yes
2. No
1. Yes
2. No
1. Yes
2. No 12.4 What was the result?
1. Pending
2. Convicted
3. Dismissed
1. Pending
2. Convicted
3. Dismissed
1. Pending
2. Convicted
3. Dismissed
SECTION 13. HOUSING AND HOUSEHOLD ITEMS – HEAD OF HOUSEHOLD ONLY
CHARACTERISTICS OF OCCUPIED BUILDING
13.1. TYPE OF BUILDING Of the type of buildings listed, which applies to the building, your household occupies?
1. Residential 2. Residential/Commercial
3. Residential/Professional (Office) 4. Commercial/Industrial
5. Community Service – Private/Gov’t 6 Other _____________________ specify 13.2. MATERIAL OF OUTERWALLS What are the construction materials of the outer-walls?
1. Brick/Concrete 2. Wood/brick/concrete 3. Wood
4. Wood/Galvanise 5. Wood/Stucco 6. Stone
7. Makeshift
13.3. WHAT IS THE MATERIAL USED FOR ROOFING?
1. Sheet Metal 2. Shingle (asphalt) 3. Shingle (wood) (Zinc, aluminum, galvanise)
4. Shingle (other) 5. Tile 6. Concrete
7. Makeshift 13.4 IN WHAT YEAR WAS THIS BUILDING CONSTRUCTED?
1. 2001 2. 2000 3. 1999
4. 1998 5. 1997 6. 1996
7. 1990-1995 8. 1989 or earlier
CHARACTERISTICS OF DWELLING UNIT OCCUPIED BY HOUSEHOLD
13.5. TYPE OF DWELLING How would you describe the type of dwelling unit that your household occupies?
1. Separate House 2. Apartment 3. Townhouse/Condominium
4. Double House/Duplex 5. Part of Com./Ind. Building 6. Barracks
7. Out-room 8. Other Private dwelling 9. Group dwelling
10. Other_______________ (Specify) 13.6. A dwelling unit must have a separate entrance and NOT BE ACCESSED OR ENTERED through someone else’s living arrangements. TENANCY Is the dwelling unit –
1. Owned 2. Rented Private 3. Rented Government
4. Leased Private 5. Leased Government 6. Rent Free
7. Squatted 8. Other__________________ (specify)
13.7. Is the land on which the dwelling stands freehold, leasehold, or some other type of occupancy?
1. Freehold 2. Leasehold 3. Rented
4. Squatted 5. Other_____________ (specify)
13.8.1. FOR RENTERS ONLY: What is the monthly rent paid for this dwelling unit? 13.8.2. FOR OWNER-OCCUPIERS ONLY: If you were to rent this dwelling unit unfurnished; how much would it fetch? SINGLE OR MULTIPLE OCCUPANCY OF A DWELLING UNIT 13.9.1. Is any part of the dwelling unit in which you live occupied by other households.
1. Yes
2. No (Skip to 12.10.1 ) 13.9.2. How many other households occupy this dwelling unit, apart from your household?
13.10.1. How many bedrooms are there in this dwelling unit? (Count all the bedrooms including spare bedrooms not occupied). Bedrooms are used mainly for sleeping and exclude makeshift and temporary sleeping quarters. TO INTERVIEWER: Question 12.10.2. applies only to heads of households living in dwelling unit occupied by more than one household. 13.10.2 How many bedrooms are occupied/available for use by your household? 13.11. How many rooms are there in your dwelling unit? (Do not count bathrooms, porches, kitchens, etc.) 13.12. What is the main source of your water supply?
1. Rainwater in cistern or tank 2. Public Piped into Dwelling (City Water
3. Desalinated, piped into dwelling 4. Well/Tank
5. Drums 6. Other_____________ (specify) 13.13. Does this household have the use of a kitchen or kitchenette with sink permanently connected to a water supply and a waste pipe?
1. Yes for the use only by this household
2. Yes shared with another household
3. Kitchen without sink permanently connected
13.14. Does this household have the use of a room with a fixed bath or shower permanently connected?
1. Yes for the use only by this household
2. Yes shared with another household
3. Room with no fixed bath or shower 13.15.1. What type of toilet facilities does this household have?
1. Flushed Toilet with Septic Tank/Soak Away
2. CessPit/Pit-latrine
3. Other _________________ (specify) 13.15.2. Are these toilet facilities shared with another household?
1. Yes
2. No 13.16.1 What type of lighting does this dwelling unit use most?
1. Electricity 2. Gas 3. Kerosene
4. Other 13.16.2. What type of fuel does this household use most for cooking?
1. Electricity 2. L. P. G. 3. Kerosene
4. Wood/Coal
HOUSEHOLD FACILITIES AVAILABLE
13.17 Does your household have any of the following items?
1. Refrigerator 2. Stove 3. Washing Machine
4. Microwave 5. Telephone 6. Computer
7. Internet Access 8. Radio 9. Television
10. Video 11. Stereo 12. Cable T.V./Dish
13. Water heater 14. Air Conditioner 13.18 How many motor vehicles are owned by members of this household? 13.19(a). How many fishing boats are owned by members of this household? 13.19(b). How many pleasure crafts (boats for pleasure) are owned by members of this household?